老人にみられた小脳半球gliomaの1例

CLINICOPATHOLOGICAL STUDY ON AN ADULT CASE OF CEREBELLAR GLIOMA:A CASE OF ANAPLASTIC MEDULLO-GLIOBLASTOMA

Ｉ．はじめに

　小脳gliomaの年齢別分布は年少者に圧倒的に多く，年齢にしたがつて少なくなり，特に60歳以上でははなはだまれである。これは周知のごとく小脳のmedulloblas—tomaおよびastrocytomaが小児に多く，一方成人に好発するglioblastomaが圧倒的に大脳に多く，小脳ではまれ^7）10），ないし皆無^11）といわれるからである。しかしこの通念に反し，小脳medulloblastomaおよびastro—cytomaが成人にもかなりみられることも事実で^5）9），また小脳のglioblastomaの存在についても相反する見解が存する^10）。

　今回，われわれは65歳の老女の小脳半球gliomaで臨床病理学的に興味ある知見を得たので報告する。

A 65-year-old female had a transient attack of tinnitus and nausea, 10 months before the death. Prior to the death, for apploximately 5 months, the patient had been suffering from dizziness, nausea, fatigue and disturbance of gait, which suggested a vascular origin. After the admission to the hospital of 19. 10. 1967, she developed stiffness of neck, mark-ed psychotic deterioration and minor cerebellar signs such as ataxia and hypotonia. A choked disk appeared at the end of the course. She died on 14. 2. 1968.

Autopsy disclosed that a henegg-sized tumor arised from the posterior pole of It. cerebellar hemisphare, developed upwards and pushed the tentorium cere-belli between the incisura cereberum. On the histc-logical examination, the tumor cells had a highly anaplastic nature such as polymorphisms, numerous mitotic figures and giant cells but its differentiation was identical with a medulloblastoma it the center of the tumor and with a astroblastoma in the peri-phery. So it could be decided as an "anaplastic medulloglioblastoma".

Cerebellar glioma in the aged patient is only seldom reported and the presence of cerebellar glioblastoma was discussed several times but we consider this form of glioma can be diagnosed as a cerebellar glioblasto-ma.